KNEE JOINT 407 



entirely replaces a portion of the capsule. Proximal to the 

 patella the capsule is represented merely by the synovial 

 stratum covering the posterior surface of the tendon of the 

 quadriceps muscle ; on the other hand the antero-medial and 

 the antero-lateral parts of the capsule have been strengthened 

 by fusion with expansions from the vasti portions of the 

 quadriceps and with the superjacent parts of the fascia lata. 

 The position and attachments of the original capsule are still 

 indicated, in the adult, by the synovial layer which forms 

 a continuous enclosing membrane except in the region of the 

 patella. 



Ligamentum Patellae. The patellar ligament is situated 

 in relation to the distal part of the front of the capsule. 

 It constitutes, at the same time, the tendon of insertion of 

 the quadriceps extensor muscle and a ligament connecting 

 the patella with the tuberosity of the tibia. Its anterior 

 surface and margins should be carefully denned. 



The ligament is a strong band, about two inches long, 

 which is attached proximally to the apex of the patella, and 

 distally to the smooth proximal part of the tuberosity of 

 the tibia. Its superficial fibres are directly continuous, over 

 the surface of the patella, with the central part of the common 

 tejidon of the quadriceps extensor. Its deep surface is 

 'separated proximally from the synovial layer by the infra- 

 patellar pad of fat, and distally it is separated from the 

 anterior surface of the proximal end of the tibia by the deep 

 infrapatellar bursa (Fig. 181). 



Ligamentum Collaterale Fibulare (O.T. External Lateral 

 Ligament). The fibular collateral ligament is rounded and 

 cord -like. It stands well away from the joint cavity, and 

 takes no part in the formation of the articular capsule. It 

 is attached proximally to a tubercle on the lateral condyle 

 of the femur ; distally, it is fixed to the head of the fibula, 

 anterior to the apex. It is closely associated with the tendon 

 of the biceps femoris and the tendon of the popliteus. It 

 splits the tendon of the biceps into two pieces, and extends 

 between them to its fibular attachment. The tendon of the 

 popliteus takes origin from the lateral condyle of the femur 

 distal to and anterior to the femoral attachment of the fibular 

 collateral ligament. As the tendon runs backwards it lies 

 under cover of the fibular collateral ligament, but is separated 

 from it by the articular capsule. 

 i 26 c 



